Lung Cancer
Topics Covered
Topics Covered
Topics Covered
Understanding Lung Cancer
Lung cancer occurs when abnormal cells grow uncontrollably within the lung tissue.
It is primarily divided into two main types:
- Non-small cell lung cancer (NSCLC): the most common form, about 85% of cases.
- Small cell lung cancer (SCLC): less common but typically more aggressive.
While strongly linked to smoking, lung cancer can also affect non-smokers due to exposure to second-hand smoke, environmental toxins or genetic mutations.
Recognising early symptoms — such as a persistent cough, chest pain, or shortness of breath — is vital for successful treatment.
Symptoms and Early Signs
Lung cancer symptoms can vary depending on the type, size, and location of the tumour.
In early stages, there may be no symptoms, which is why many cases are discovered incidentally during imaging for another reason.
However, recognising the following signs can lead to earlier diagnosis and better outcomes.
Common symptoms include:
- Persistent cough that doesn’t go away or gets worse
- Coughing up blood or rust-coloured sputum
- Shortness of breath
- Chest pain that worsens with deep breathing or coughing
- Unexplained fatigue or weight loss
- Hoarseness or wheezing
- Recurrent respiratory infections (such as bronchitis or pneumonia)
Less commonly, lung cancer can cause shoulder or bone pain, swelling in the face or neck, or symptoms related to metastasis such as headaches or neurological changes.
Anyone experiencing persistent respiratory symptoms — especially those with a history of smoking or significant exposure to pollutants — should seek medical assessment promptly.
Diagnosing Lung Cancer
Early and accurate diagnosis is key to effective treatment. Many cases are identified when a patient reports symptoms, while some are found incidentally on scans done for other reasons. Detecting lung cancer early allows for more treatment options and better outcomes.
The diagnostic pathway usually includes imaging to visualise the tumour, a biopsy to confirm the cancer type, and molecular profiling to guide targeted and immunotherapy options. Your case is discussed in a multidisciplinary team (MDT) to create a precise, individualised plan.
Common Diagnostic Investigations
Imaging tests
- Chest X-ray: first-line test to detect masses or abnormalities.
- CT scan (computed tomography): detailed 3-D images to assess size and spread.
- PET scan: shows metabolically active cancer cells.
- MRI: used when more detail is needed, especially for brain or spine involvement.
Biopsy (tissue sampling)
A small sample is taken — via bronchoscopy, needle biopsy, or minimally invasive surgery — and examined microscopically to confirm cancer type (NSCLC or SCLC).
Molecular profiling & genetic testing
Modern diagnosis includes biomarker and mutation testing to guide personalised, targeted therapies.
Multidisciplinary Team (MDT)
Every case is reviewed by a team of oncologists, surgeons, radiologists and respiratory physicians to create a precise, individualised treatment plan.
Treatment of Early-Stage Non-Small Cell Lung Cancer (NSCLC)
When detected early, NSCLC is often treatable with curative intent.
The focus is on removing or destroying the tumour while preventing recurrence.
- Surgery — main treatment for stage I and some stage II cancers.
- Procedures include lobectomy (removal of a lung lobe) or, in selected cases, segmentectomy/wedge resection.
- Adjuvant therapy — post-surgical chemotherapy or radiotherapy to reduce recurrence risk.
- Targeted therapy & immunotherapy — may be added when genetic mutations (e.g. EGFR) are present.
Early detection allows for less invasive approaches and significantly better long-term survival.
Treatment of Locally Advanced NSCLC
In locally advanced stages, the cancer has spread to nearby tissues or lymph nodes and is often not suitable for surgery.
The standard approach combines chemotherapy and radiotherapy to shrink and control the tumour.
Recent advances include consolidation immunotherapy with durvalumab, which improves progression-free survival, and third-generation EGFR inhibitors such as osimertinib for patients with specific mutations.
These therapies mark a major step forward in prolonging life and maintaining wellbeing.
Treatment of Oligometastatic NSCLC
“Oligometastatic” refers to cancer that has spread beyond the lungs but only to a few defined sites (typically ≤ 5).
This intermediate stage allows for aggressive, localised treatment with curative intent.
- Local therapy: surgery or stereotactic body radiotherapy (SBRT) precisely targets limited metastases while sparing healthy tissue.
- Systemic therapy: chemotherapy, immunotherapy or targeted drugs to control microscopic disease.
Studies show that combining systemic and local treatments can extend survival and improve quality of life — offering real hope to patients with limited metastatic disease.
Small Cell Lung Cancer (SCLC)
Early-Stage SCLC:
Typically treated with combined chemotherapy and radiation using drugs such as cisplatin or carboplatin plus etoposide, followed by chest radiotherapy.
Prophylactic cranial irradiation (PCI) may be given to prevent brain metastases.
The introduction of durvalumab (anti-PD-L1 immunotherapy) has recently shown further improvement in outcomes, marking a significant advancement in managing early-stage SCLC.
Extensive-Stage SCLC:
When the cancer has spread beyond the chest, treatment focuses on controlling disease and extending survival.
The combination of chemotherapy and immunotherapy — using agents like atezolizumab or durvalumab with carboplatin and etoposide — has demonstrated meaningful improvements in response and overall survival.
Your Lung Cancer Care Journey
Step 1
Rapid Initial Consultation
Quick access to an expert lung cancer specialist. Your first appointment focuses on understanding your history, symptoms, and initial test results, ensuring no time is lost before diagnosis.
Step 2
Comprehensive Testing & Review
Advanced imaging and diagnostic investigations are arranged promptly. Dr Papadatos-Pastos reviews all results carefully to confirm the exact type and stage of your cancer.
Step 3
Personalised Treatment Planning
Every patient’s situation is unique. Your treatment plan is tailored to your needs, incorporating the most effective and up-to-date therapies available.
Step 4
Targeted & Advanced Therapy
Treatment may include surgery, radiotherapy, chemotherapy, immunotherapy or targeted medicines — all delivered with precision and coordination by a multidisciplinary team.
Step 5
Ongoing Care & Follow-Up Support
After treatment, continued care ensures your recovery and wellbeing. Regular reviews, symptom monitoring, and emotional support are all part of your long-term plan.
Support and Follow-Up Care
Dr Papadatos-Pastos and his team provide ongoing support beyond medical treatment.
Patients receive clear communication, psychological care and access to nutrition, physiotherapy and symptom-management services.
Regular follow-up ensures early detection of recurrence and long-term wellbeing.
Book a Consultation
If you or someone close to you has been diagnosed with lung cancer, early consultation with a specialist can make a real difference. Appointments are available at several London clinics.
Faq
Answers to Common Questions
Explore some of the most frequently asked questions about lung cancer care and what to expect during treatment.
Most cases are related to smoking, but non-smokers can develop lung cancer due to second-hand smoke, environmental exposure or genetic changes.
Early-stage disease can often be cured. In advanced stages, modern therapies can control cancer for long periods and maintain a good quality of life.
Each case is reviewed in an MDT meeting so that all aspects — clinical, molecular, and personal — inform a personalised plan.
CONDITIONS TREATED
Dr Dionysis Papadatos-Pastos specialises in diagnosing and treating complex thoracic cancers with evidence-based therapies and compassionate care.
